The Efficacy of Utility Functions for Multicriteria Hospital Case-Mix Planning

A new approach to perform hospital case-mix planning (CMP) is introduced in this article. Our multi-criteria approach utilises utility functions (UF) to articulate the preferences and standpoint of independent decision makers regarding outputs. The primary aim of this article is to test whether a utility functions method (UFM) based upon the scalarization of aforesaid UF is an appropriate quantitative technique to, i) distribute hospital resources to different operating units, and ii) provide a better capacity allocation and case mix. Our approach is motivated by the need to provide a method able to evaluate the trade-off between different stakeholders and objectives of hospitals. To the best of our knowledge, no such approach has been considered before in the literature. As we will later show, this idea addresses various technical limitations, weaknesses, and flaws in current CMP. The efficacy of the aforesaid approach is tested on a case study of a large tertiary hospital. Currently UF are not used by hospital managers, and real functions are unavailable, hence, 14 rational options are tested. Our exploratory analysis has provided important guidelines for the application of these UF. It indicates that these UF provide a valuable starting point for planners, managers, and executives of hospitals to impose their goals and aspirations. In conclusion, our approach may be better at identifying case mix that users want to treat and seems more capable of modelling the varying importance of different levels of output. Apart from finding desirable case mixes to consider, the approach can provide important insights via a sensitivity analysis of the parameters of each UF.Comment: 35 pages, 6 tables, 29 figure

A novel TOPSIS–CBR goal programming approach to sustainable healthcare treatment

Cancer is one of the most common diseases worldwide and its treatment is a complex and time-consuming process. Specifically, prostate cancer as the most common cancer among male population has received the attentions of many researchers. Oncologists and medical physicists usually rely on their past experience and expertise to prescribe the dose plan for cancer treatment. The main objective of dose planning process is to deliver high dose to the cancerous cells and simultaneously minimize the side effects of the treatment. In this article, a novel TOPSIS case based reasoning goal-programming approach has been proposed to optimize the dose plan for prostate cancer treatment. Firstly, a hybrid retrieval process TOPSIS–CBR [technique for order preference by similarity to ideal solution (TOPSIS) and case based reasoning (CBR)] is used to capture the expertise and experience of oncologists. Thereafter, the dose plans of retrieved cases are adjusted using goal-programming mathematical model. This approach will not only help oncologists to make a better trade-off between different conflicting decision making criteria but will also deliver a high dose to the cancerous cells with minimal and necessary effect on surrounding organs at risk. The efficacy of proposed method is tested on a real data set collected from Nottingham City Hospital using leave-one-out strategy. In most of the cases treatment plans generated by the proposed method is coherent with the dose plan prescribed by an experienced oncologist or even better. Developed decision support system can assist both new and experienced oncologists in the treatment planning process

Artificial Intelligence in Radiotherapy Treatment Planning: Present and Future.

Treatment planning is an essential step of the radiotherapy workflow. It has become more sophisticated over the past couple of decades with the help of computer science, enabling planners to design highly complex radiotherapy plans to minimize the normal tissue damage while persevering sufficient tumor control. As a result, treatment planning has become more labor intensive, requiring hours or even days of planner effort to optimize an individual patient case in a trial-and-error fashion. More recently, artificial intelligence has been utilized to automate and improve various aspects of medical science. For radiotherapy treatment planning, many algorithms have been developed to better support planners. These algorithms focus on automating the planning process and/or optimizing dosimetric trade-offs, and they have already made great impact on improving treatment planning efficiency and plan quality consistency. In this review, the smart planning tools in current clinical use are summarized in 3 main categories: automated rule implementation and reasoning, modeling of prior knowledge in clinical practice, and multicriteria optimization. Novel artificial intelligence-based treatment planning applications, such as deep learning-based algorithms and emerging research directions, are also reviewed. Finally, the challenges of artificial intelligence-based treatment planning are discussed for future works

Designing Medical Treatment Protocols To Improve Healthcare Supply Chain Management

The primary goal of this research is to determine the strategic system integration opportunities for a segmented healthcare system with cost minimization and efficacy maximization objectives. This research is inspired in part by the Defense Logistics Agency, which is trying to assess the impact of integrating treatment selection processes across service clinicians. Specifically, physician bias, patient volumes, leveraging economies of scale or costing structures, and complex treatment efficacy calculations are considered by mathematically modeling three forms of integration. Multiple objective optimization problems are used to define efficient frontiers based on cost and treatment efficacy. A novel comparative analysis method is applied to measure improvements in efficient frontiers and a customized genetic algorithm solution is applied for the more complex treatment selection problem. Results indicate that more integrated treatment selection protocols lead to decreases in cost alongside increases in efficacy. Complex healthcare systems or systems with higher variability in performance factors are found to have the greatest opportunity for performance improvement

A Review and Classification of Approaches for Dealing with Uncertainty in Multi-Criteria Decision Analysis for Healthcare Decisions

Multi-criteria decision analysis (MCDA) is increasingly used to support decisions in healthcare involving multiple and conflicting criteria. Although uncertainty is usually carefully addressed in health economic evaluations, whether and how the different sources of uncertainty are dealt with and with what methods in MCDA is less known. The objective of this study is to review how uncertainty can be explicitly taken into account in MCDA and to discuss which approach may be appropriate for healthcare decision makers. A literature review was conducted in the Scopus and PubMed databases. Two reviewers independently categorized studies according to research areas, the type of MCDA used, and the approach used to quantify uncertainty. Selected full text articles were read for methodological details. The search strategy identified 569 studies. The five approaches most identified were fuzzy set theory (45 % of studies), probabilistic sensitivity analysis (15 %), deterministic sensitivity analysis (31 %), Bayesian framework (6 %), and grey theory (3 %). A large number of papers considered the analytic hierarchy process in combination with fuzzy set theory (31 %). Only 3 % of studies were published in healthcare-related journals. In conclusion, our review identified five different approaches to take uncertainty into account in MCDA. The deterministic approach is most likely sufficient for most healthcare policy decisions because of its low complexity and straightforward implementation. However, more complex approaches may be needed when multiple sources of uncertainty must be considered simultaneousl

Customers satisfaction in pediatric inpatient services: A multiple criteria satisfaction analysis

Objective: To assess customer satisfaction determinants in a public pediatric inpatient service and propose some strategies to enhance the consumer and customer experience. Methods: We applied a Multiple Criteria Customer Satisfaction Analysis to estimate the value functions associated with each satisfaction (sub)criterion and determine the corresponding weights. We characterized satisfaction criteria (according to the Kano’s model), estimated the customers’ demanding nature and the potential improvements, and proposed strategic priorities and opportunities to enhance customer satisfaction. Main findings: Strategies for satisfaction enhancement do not depend solely on the criteria with the lowest satisfaction levels and the estimated weights, each criterion’s nature, the customers’ demanding nature, and the technical margin for improvements. Conclusions: Areas deserving attention include clinical staff’s communication skills, the non-clinical professionals’ efficiency, availability, and kindness; food quality; visits’ scheduling and quantity; and facilities’ comfort.info:eu-repo/semantics/publishedVersio

A Review and Classification of Approaches for Dealing with Uncertainty in Multi-Criteria Decision Analysis for Healthcare Decisions

The Author(s) 2015. This article is published with open access at Springerlink.com Abstract Multi-criteria decision analysis (MCDA) is increasingly used to support decisions in healthcare involving multiple and conflicting criteria. Although uncertainty is usually carefully addressed in health eco-nomic evaluations, whether and how the different sources of uncertainty are dealt with and with what methods in MCDA is less known. The objective of this study is to review how uncertainty can be explicitly taken into account in MCDA and to discuss which approach may be appro-priate for healthcare decision makers. A literature review was conducted in the Scopus and PubMed databases. Two reviewers independently categorized studies according to research areas, the type of MCDA used, and the approach used to quantify uncertainty. Selected full text articles wer